antibiotics - side effects

what is the most common side effect of penicillins?

diarrhoea (GI upset)

what is an important side effect of penicillins?

hypersensitivity reactions:

- skin rash (10%)

- anaphylaxis (<0.05%)

what condition should amoxicillin not be used in?

infectious mononucleosis

what happens if amoxicillin is taken in infectious mononucleosis?

rash

what is a side effect of co-amoxiclav and flucoxacillin?

cholestasis

what are the side effects of glycopeptides (vancomycin)?

- hypotension

- nephrotoxicity

- redman syndrome

when may ototoxicity occur with vancomycin?

if co-prescribed with another ototoxic medication (loop diuretics/aminoglycosides)

what causes redman syndrome?

rapid infusion of vancomycin

what are the features of redman syndrome?

rash, flushing and pruritus

what are the side effects of erythromycin?

- vomiting - GI upset

- prolongs QT interval

- hepatic toxicity

- ototoxicity

- inhibition of cytochrome p450 enzymes

what are the side effects of clarithromycin?

- QT interval prolongation

- hepatic toxicity

- GI upset - vomiting (but less common that erythromycin)

- C.diff - diarrhoea

what are the side effects of azithromycin?

- GI upset - vomiting

- hepatic toxicity

- hearing loss and tinnitus (ototoxic)

what are the side effects of quinolones (ciprofloxacin)?

- lowers seizure threshold

- achilles tendonitis

- lengthens QT interval

what increases the risk of tendonitis?

if pt is also taking steroids

what are the side effects of doxycycline?

- photosensitivity

- GI upset

- idiopathic intracranial hypertension

- children - discolouration of teeth + inhibition of bone growth

what are the side effects of aminoglycosides?

- ototoxicity - tinnitus, vertigo, ataxia

- nephrotoxicity

what are the side effects of trimethoprim?

- rashes

- photosensitivity

- pruritus

- suppression of haemotopoeisis

- rise in creatinine

does the rise in creatinine when using trimethoprim change the actual GFR?

no, but it changes the estimated GFR (eGFR)

what are the side effects of metronidazole taken IV?

dry mouth, nausea and vomiting

what are the side effects of metronidazole taken vaginally?

vaginal candidiasis and dryness

what are the side effects of metronidazole taken orally?

- cerebellar syndrome

- agranulocytosis

- black hairy tongue